esophageal perforation repair- related, 155

157 A

Abscess subhepatic

esophagectomy-related, 33 esophagogastrectomy-related,

34 subphrenic

esophageal perforation repair- related, 155

esophagectomy-related, 33 esophagogastrectomy-related, 34 Achalasia

cricopharyngeal, 8 pathology of, 10

treatment of, 10–11, 139–143 with laparoscopic

esophagomyotomy, 144–149 Allis clamp, 111

Anastomoses cervical, 9–10

leakage from, 9–10 strictures of, 71

cologastric, in short segment colon interposition, 81

end-to-end esophageal complications of, 35–36 versus end-to-side anastomosis,

35–36

stapling technique in, 36 end-to-side esophageal, 13, 25, 27,

28

cervical, 29–31

with enlarged thoracic incision, 50–52

in esophageal replacement, 3 in esophagogastrectomy with

left thoracoabdominal approach, 35–36, 50–60 with Nissen fundoplication, 55 Nissen fundoplication in, 27 stapled, 27

stapling technique (circular technique) in, 52, 58–60 stapling technique (surgical

legacy technique) in, 52, 54–58

supraaortic, 50–52 suture technique in, 52 esophagocolonic

in long segment colon interposition, 79

in short segment colon interposition, 81 esophagogastric, 70

in gastric cardia carcinoma, 1 Anastomotic leaks

bile diversion operations-related, 132

cervical

cervical anastomosis-related, 9–10

intrathoracic anastomosis- related, 2

esophagectomy-related, 13, 33 esophagogastrectomy-related, 34,

35

intrathoracic anastomosis-related, 10

nonsurgical treatment of, 10 surgical treatment of, 10,

150–156

transhiatal esophagectomy-related, 66, 71

Antibiotic prophylaxis, for postoperative abscesses, 33 Antibiotic therapy, for anastomotic

leaks, 10 Antireflux operations, 6

failed, 7

as indication for bile diversion procedures, 127

for hiatal hernia/reflux, 4 manometry use in, 5

posterior gastropexy (Hill repair), 107–114

transabdominal Nissen fundoplication, 85–94 transthoracic gastroplasty, 81,

115–126

Antireflux valve, testing of in posterior gastropexy, 114 in transabdominal Nissen

fundoplication, 92–93 Antrectomy, in bile diversion

procedures, 127, 128 Aorta, posterior gastropexy-related

laceration of, 108, 111 Arrhythmias, cardiac, esophagectomy-

related, 33 Azygos vein, transhiatal

esophagectomy-related trauma to, 67

B

Barotrauma, as esophageal perforation cause, 9 Barrett’s esophagus

esophageal carcinoma associated with, 6

surgical treatment of with antireflux surgery, 5 with laparoscopic Nissen

fundoplication, 95–106 Bile diverting operations, 127–133

after esophagogastrectomy, 128–130 duodenojejunostomy in,

128–129, 130 complications of, 127, 132 duodenojejunostomy Roux-en-Y

switch operation, 131–132 indications for, 127

operative strategy in, 127–128 after esophagogastrectomy, 128 after failed antireflux

procedures, 127

operative technique in, 128–132 pitfalls and danger points in, 127 preoperative preparation for, 127 vagotomy and antrectomy, 127,

128

closure in, 128

hemigastrectomy in, 128 Roux-en-Y reconstruction in,

127, 128

Blast injuries, as thoracic esophageal perforation cause, 9

Boerhaave syndrome, 9 Botulinum toxin, as achalasia

treatment, 10 Bougies, Maloney, 7, 33 Bowel herniation

laparoscopic Nissen

fundoplication-related, 95, 102 transhiatal esophagectomy-related,

66

Bypass, esophageal. See Esophageal replacement or bypass procedures

C

Candida, esophageal content of, 8 Celiac artery, in posterior gastropexy

identification and liberation of, 111

laceration of, 108

Chest tube drainage, in esophageal perforation repair, 151, 152, 155

Chylothorax, transhiatal

esophagectomy-related, 66 Clamps

Allis, 54, 55

Babcock, 87, 111, 121 endoscopic, 96, 97 Mixter, 121

Collis-Nissen operation. See Gastroplasty, transthoracic Cologastrostomy, in long segment

colon interposition, 74–77, 78

Colon interposition disadvantages of, 3–4 long segment, 73–79

advancement of the colon in, 77, 79

cervical esophagus dissection in, 79

closure of, 801

cologastrostomy in, 74–77, 78 esophagocolonic anastomosis in,

79

estimation of required length of colon in, 74, 75

pyloromyotomy in, 77 retrosternal passage of colon

transplant in, 79, 80–81 short segment, 79, 81

cologastric anastomosis in, 81 esophagocolonic anastomosis

in, 81

in unresectable esophageal carcinoma, 2

Cricopharyngeus muscle, 7

D

Diaphragm incision of, in

esophagogastrectomy with left thoracoabdominal approach, 38, 39

paralysis of, esophagogastrectomy- related, 34

Dilators

as esophageal perforation cause, 9

Goodall cervical, 111 Maloney, 105, 115, 137

in transthoracic gastroplasty, 120, 121–122, 124

Diverticulum, pharyngoesophageal.

See Zenker’s

(pharyngoesophageal) diverticulum

Duodenojejunostomy Roux-en-Y switch operation, 131

Dysphagia

achalasia-related, 10 postoperative

cricopharyngeal myotomy- related, 138

esophagomyotomy-related, 143 fundoplication-related, 6 laparoscopic Nissen

fundoplication-related, 102, 106

posterior gastropexy-related, 111, 114

transabdominal Nissen fundoplication-related, 86 Zenker’s (pharyngoesophageal)

diverticulum-related, 8

E

Emphysema, mediastinal, 9

Empyema, esophagomyotomy-related, 143

Endoscopes, as esophageal perforation cause, 9 Epidural analgesia/anesthesia

in esophagectomy patients, 33 in esophagogastrectomy with left

thoracoabdominal approach, 34

in gastric cardia patients, 1 Esophageal carcinoma

of the cardiac region, 1 surgical treatment of

with esophagectomy with right thoracotomy and laparotomy, 13–33

with esophagogastrectomy with left thoracoabdominal approach, 34–65 with thoracic esophageal

reconstruction, 29

transhiatal approach in, 2–3, 66–71

transthoracic approach in, 2–3 unresectable, 2

Esophageal hiatus, enlargement of, 13 Esophageal perforations, 8–9

antibiotic therapy for, 9 of cervical esophagus, 8, 9

“conservative” management of, 8 delayed diagnosis of, 150 esophagitis as risk factor for, 108 laparoscopic esophagomyotomy-

related, 144, 149 laparoscopic Nissen

fundoplication-related, 95, 98, 100, 105, 106

occult, 10

operative repair of, 9, 150–156 with colon or jejunum

interpositions, 73–81

complications of, 150, 155 débridement in, 150–151, 152 esophageal diversion by cervical

esophagostomy, 153–154 esophageal occlusion methods,

153

exclusion of the esophagus from the gastrointestinal tract, 154–155

intercostal muscle flap repair, 151, 152

operative strategy in, 150 operative technique in, 150–155 pitfalls and danger points in, 150 pleural flap repair, 150–152 postoperative care following,

155

preoperative preparation for, 150

of thoracic esophagus, 9

transthoracic gastroplasty-related, 115

Esophageal replacement or bypass procedures, 3–4, 73–84 colon interposition, long segment,

73–79

advancement of the colon in, 77, 79

cervical esophagus dissection in, 79

closure of, 801

cologastrostomy in, 74–77, 78 esophagocolonic anastomosis in,

79

estimation of required length of colon in, 74, 75

pyloromyotomy in, 77 retrosternal passage of colon

transplant in, 79, 80–81 colon interposition, short segment,

79, 81

cologastric anastomosis in, 81 esophagocolonic anastomosis in,

81

indications for, 73

jejunum interposition, 81–83 with Collis-Nissen gastroplasty,

81

esophagojejunostomy in, 82 incision in, 81

jejunogastrostomy in, 82, 83 jejunojejunostomy in, 82 mobilization of jejunum graft in,

82

pyloromyotomy in, 83 pyloroplasty in, 83

resection of diseased esophagus in, 81–82

Stamm gastrostomy in, 82

operative strategy in, 73

operative technique in, 73–83 incision, 73

long segment colon interposition, 73–79 resection of the esophagus, 73 short segment colon

interposition, 79, 81 preoperative preparation for, 73 stomach interposition for, 3 Esophageal strictures. See Strictures,

esophageal

Esophageal surgery. See also specific esophageal surgical

procedures concepts in, 1–12

achalasia, 10–11

anastomotic leaks, 8, 9–10 carcinoma of the cardia region, 1 carcinoma of the middle and

upper esophagus, 1–2 esophageal perforations, 8–9 hiatal hernia and reflux disease,

4–7

motility disorders, 11 pharnygoesophageal diverticulum, 7–8

replacement or bypass of the esophagus, 3–4

transhiatal approach in esophageal carcinoma, 2–3 transthoracic approach in

esophageal carcinoma, 2–3 unresectable carcinoma, 2 Esophagectomy

with right thoracotomy and laparotomy, 13–33

access to proximal esophagus in, 13

advancement of stomach into right chest in, 23–24, 25 cervical esophagogastric

anastomosis in, 29–31 closure of, 31–32 complications of, 13, 33 esophagogastric anastomosis in,

13, 25–27, 28

gastroepiploic arcade in, 13, 19 incisions in, 13–17

indications for, 13

Kocher maneuver in, 20–21, 22 mobilization of the esophagus

in, 16, 17

mobilization of the stomach in, 17–20

operative strategy in, 13 operative technique in, 13–32 patient positioning in, 13 pitfalls and danger points in, 13 postoperative care following, 33 preoperative preparation for, 13

pyloromyotomy in, 21–23 stapled esophagogastric

anastomosis in, 27 transhiatal, 2–3, 66–71

abdomen in, 67

cervical dissection in, 66–67 closure of, 71–72

complications of, 66, 71 Kocher maneuver in, 67 operative strategy in, 66–67 operative technique in, 67–71 pitfalls and danger points in, 66 preoperative preparation for, 66 pyloromyotomy in, 67

transhiatal dissection in, 67–70, 71

Esophagitis

as esophageal perforation risk factor, 108

reflux, 5

esophagogastrectomy-related, 36 esophagogastric anastomosis-

related, 27

esophagomyotomy-related, 143 as indication for laparoscopic

Nissen fundoplication, 95 Esophagogastrectomy

bile diversion following, 128–130 duodenojejunostomy in, 128–

129

Roux-en-Y reconstruction in, 129, 130

left thoracoabdominal approach in, 34–65

closure of, 61–64 complications of, 34, 64 endobronchial one-lung

anesthesia in, 36–37 end-to-side anastomosis in,

35–36, 50–60

enlargement of hiatus in, 48, 49, 50

enlargement of thoracic incision in, 50–52

gastric mobilization in, 42–45 hiatal dissection in, 45 incision in, 36–38, 39–40 Kocher maneuver in, 45, 46 latissimus dorsi division in,

37–38

liberation of the esophagus in, 38, 40, 41

with Nissen fundoplication, 36, 55

operative strategy in, 34–36 operative technique in, 36–64 patient positioning in, 37 pitfalls and danger points in, 34 postoperative care following, 64 preoperative preparation for, 34

pyloromyotomy in, 45 splenectomy in, 40, 42

stabilization of the gastric pouch in, 60–61

stapling technique in, 36 transection of stomach and

esophagus in, 45–48 Esophagogastric junction

in esophageal perforation repair, 9 in paraesophageal hernias, 5 in posterior gastropexy (Hill

repair), 108–111 in transabdominal Nissen

fundoplication, 85, 86–87, 91 Esophagogastroduodenoscopy, prior

to transabdominal Nissen fundoplication, 85 Esophagojejunostomy

in jejunum interposition, 82 Roux-en-Y, 1

Esophagomyotomy

as achalasia treatment, 139–143, 144–149

incision and exposure, 140 operative strategy in, 139 operative technique in, 140–143 pitfalls and danger points in,

139

preoperative preparation for, 139

complications of, 139, 143 as diffuse esophageal spasm

treatment, 139, 143 laparoscopic, 144–149

complications of, 144, 149 esophageal mobilization in,

145–146 indications for, 144

initial exposure in, 145–146 myotomy in, 144, 146–148 operative strategy, 144–148 partial fundoplication in, 148 patient positioning in, 144 pitfalls and danger points in, 144 preoperative preparation for,

144

trocar placement in, 144 postoperative care following, 143 as Zenker’s diverticulum treatment,

137–138

Esophagoscopy, for gastroesophageal reflux evaluation, 5

Esophagostomy

anterior thoracic, 150, 154 cervical, for esophageal diversion,

153–154 Esophagus

cervical, division of, 70 dissection of

in transhiatal esophagectomy, 68

Esophagus (cont.)

exclusion from the gastrointestinal tract, 151, 154–155

intraoperative injury to during esophageal stricture

dilation, 120–121 during laparoscopic Nissen

fundoplication, 95 mobilization/liberation of

in esophageal perforation repair, 150, 153

in esophagectomy, 16, 17 in esophagogastrectomy with

left thoracoabdominal approach, 38, 40, 41 in laparoscopic

esophagomyotomy, 145–146 in laparoscopic Nissen

fundoplication, 95, 100–102 in transthoracic gastroplasty,

115, 118, 119 penetrating trauma to, 152 perforation of. See Esophageal

perforation

short, transthoracic gastroplasty repair of, 115–126

transection of, in

esophagogastrectomy, 45, 48, 49

F Fistulas

esophageal, cricopharyngeal myotomy-related, 138

esophagocutaneous, postoperative, 155

pancreatic, esophagogastrectomy- related, 34

Flap repair

intercostal muscle, of esophageal perforation, 152, 153 pleural, of thoracic esophageal

perforation, 150–152 Foley catheter balloon, for

esophageal lumen dilatation, 55, 58

Fundoplication. See also Nissen fundoplication

abdominal approach in, 6, 7 complications of, 6

intrathoracic approach in, 7 partial

Dor, 144, 148 Toupet, 144, 148 thoracic approach in, 6, 7

G

“Gas bloat,” 93 Gastrectomy

proximal, 1

subtotal, as indication for

transthoracic gastroplasty, 115 Gastric artery, left

in esophagogastrectomy, 42, 44 in transabdominal Nissen

fundoplication, 85

Gastric cardia carcinoma, resection of, 1

Gastric fundus, mobilization of, in transabdominal Nissen fundoplication, 85, 87, 90, 91 Gastric pouch

esophagogastrectomy-related ischemia of, 34

stabilization of, in

esophagogastrectomy with thoracoabdominal approach, 60–61

Gastric pull-up operation, 154–155 Gastric tip, transhiatal

esophagectomy-related trauma to, 66

Gastrocolic reflux, esophageal replacement-related, 3 Gastroepiploic arcades, 3

in esophagectomy, 13, 19 in esophagogastrectomy, 42–43 right, in transhiatal esophagectomy,

67

Gastroepiploic artery, in transhiatal esophagectomy, 66, 67 Gastroesophageal reflux (GER). See

also Esophagitis, reflux esophageal strictures associated

with, 6–7

hiatal hernia-related, 4, 5–6 postoperative

Collis-Nissen procedure-related, 126

following posterior gastropexy, 114

laparoscopic esophagomyotomy- related, 144, 149

preoperative evaluation of, 5 surgical treatment of, 6

failure of, 7

posterior gastropexy (Hill repair), 107–114 transabdominal Nissen

fundoplication, 85–94 transthoracic gastroplasty,

115–126 Gastrohepatic ligament

division of, 108, 110 location of, 85

proximal, division of, 85

in transthoracic gastroplasty, 118, 120

Gastropexy, posterior (Hill repair), 107–114

abdominal closure in, 114 antireflux valve testing in, 114 calibration of the esophagocardiac

orifice in, 108 complications of, 107, 114 dissection of median arcuate

ligament in, 107–108 Hill’s modification of, 107, 111 identification and liberation of the

median arcuate ligament in, 107, 111–112

incision and exposure techniques in, 108

insertion of the crural sutures in, 111

liberation of the left lobe of the liver in, 108

mobilization of the

esophagogastric junction in, 108–111

operative strategy in, 107–108 operative technique in, 108–114 pitfalls and dangers in, 107 postoperative care following, 114 suturing techniques in, 112–114 Vansant’s modification of, 107,

112

Gastrophrenic ligament division of, 67, 110

in esophagogastrectomy, 42, 45 in transabdominal Nissen

fundoplication, 85 identification of, 85

Gastroplasty, transthoracic (Collis- Nissen procedure), 81, 115–126

adequacy of gastroplasty in, 115 closure of the hiatal defect in, 124,

125

complications of, 115, 126 contraindication to, 115

division of the short gastric vessels in, 121

esophageal perforation prevention in, 116

esophageal stricture dilation in, 120–121

esophagus and stomach mobilization in, 115

excision of the hernial sac in, 118, 119–120

gastroplasty in, 121–122, 123 hemorrhage prevention in, 115–116 incision in, 116–118

indications for, 115

liberation of the esophagus in, 118, 119

modified Nissen fundoplication in, 122, 123, 124

neoesophagus in, 115

operative strategy in, 115–116 operative technique in, 116–125 pitfalls and danger points in, 115 postoperative care following, 126 preoperative preparation for, 115 Gastrosplenic ligament, in

transabdominal Nissen fundoplication, 85–86 Gastrostomy, Stamm, 154

in jejunum interposition, 82 Gerota’s fascia, 20–21 Graspers, closed, 98, 99

H

H

2

-blockers, 5

Hemigastrectomy, in bile diverting procedures, 128

Hemodynamic monitoring, in transhiatal esophagectomy patients, 67

Hemorrhage

esophagogastrectomy-related, 34 posterior gastropexy-related, 111 transhiatal esophagectomy-related,

66, 67

transthoracic gastroplasty-related, 115

prevention of, 115–116 Hepatic arteries

left

division of, 85

posterior gastropexy-related injury to, 107

left accessory

in esophagogastrectomy, 42, 45 in transthoracic gastroplasty,

118, 120 replaced, 100

Hepatic vein, Nissen fundoplication- related injury to, 85

Hernia

diaphragmatic, esophagomyotomy- related, 143

hiatal, 4–5 incarcerated, 5 paraesophageal, 4, 5, 7 posttraumatic, 4–5 repair of, 85 sliding, 4, 5–6

Hill repair. See Gastropexy, posterior (Hill repair)

Hydropneumothorax, esophageal perforation-related, 9 Hypaque swallow, 106 Hypotension, transhiatal

esophagectomy-related, 66

I

Instruments, as esophageal perforation cause, 9

Intercostal muscle flap repair, of esophageal perforations, 151, 152, 153

Intercostal muscles, division of in esophagogastrectomy with left

thoracoabdominal approach, 38, 39

in transthoracic gastroplasty, 116 Intercostal nerves, in

esophagogastrectomy with left thoracoabdominal approach, 50, 51

Intestinal obstruction, bile diversion operations-related, 132

J

Jejunogastrostomy, in jejunum interposition, 82, 83 Jejunojejunostomy, in jejunum

interposition, 82 Jejunum interposition, 81–83

with Collis-Nissen gastroplasty, 81 disadvantages of, 3–4

esophagojejunostomy in, 82 incision in, 81

jejunogastrostomy in, 82, 83 jejunojejunostomy in, 82

mobilization of jejunum graft in, 82 pyloromyotomy in, 83

pyloroplasty in, 83

resection of diseased esophagus in, 81–82

Stamm gastrostomy in, 82

K

Kocher maneuver

in duodenojejunostomy Roux-en-Y switch operation, 131

in esophagectomy, 20–21, 22 in esophagogastrectomy with left

thoracoabdominal approach, 45, 46

in transhiatal esophagectomy, 67 Kyphoscoliosis, paraesophageal hiatal

hernia-related, 4

L

Laparoscopy, for hiatal hernia-related gastroesophageal reflux treatment, 5–6

Latissimus dorsi muscle, division of in esophagogastrectomy, 37–38 in transthoracic gastroplasty, 116

M

Manometry, esophageal

for esophagocardiac junction pressure measurement, 108 for gastroesophageal reflux

evaluation, 5

prior to transabdominal Nissen fundoplication, 85

Median arcuate ligament

identification and liberation of, 107, 111–112

Hill’s method for, 107, 111 Vansant’s method for, 107, 112 suturing of, 112

Mediastinitis, esophageal perforation- related, 150–151

Motility disorders, of the esophagus, 11. See also Achalasia Myotomy. See also

Esophagomyotomy;

Pyloromyotomy

balloon, as achalasia treatment, 10–11

cricopharyngeal, as Zenker’s diverticulum treatment, 134–138

closure of, 138 complications of, 138

dissection technique in, 136–137 incision and exposure in,

134–136

myotomy technique in, 137–138 operative strategy in, 134 operative technique in, 134–138 postoperative care following,

138

preoperative preparation for, 134

Heller, as achalasia treatment, 10–11

N Neck

dissection of, in transhiatal esophagectomy, 67

esophageal diversion in, 153–154 esophagogastric reconstruction in,

29–21

perforations of, 150 Nissen fundoplication

definition of, 6

with esophageal anastomosis, 27 end-to-side anastomosis, 55 in esophagogastrectomy with left

thoracoabdominal approach, 36, 55

laparoscopic, 95–106 complications of, 95, 106 creation of the wrap in, 95,

105–106

dissection of the hiatus in, 96, 98–100

exposure of the hiatus in, 95, 96, 97

identification of the esophagus

in, 98

Nissen fundoplication (cont.) indications for, 95

mobilization of the esophagus in, 95, 100–102

operating room setup for, 95–96 operative strategy in, 95 operative technique in, 95–106 patient positioning in, 95–96 pitfalls and dangers in, 95 postoperative care following,

106

preoperative preparation for, 95 short gastric vessel division in,

95, 102, 103–105 trocar placement in, 96 transabdominal, 85–94

abdominal closure in, 93 antireflux valve testing in, 92–93 complications of, 85, 86, 93 gastric fundus mobilization in,

85

hiatal defect repair in, 91 incision in, 87

indications for, 85

length of the fundoplication, 86, 92

mobilization of the esophagus in, 87–90

mobilization of the gastric fundus in, 85, 87, 90, 91 operative strategy for, 85–87 operative technique for, 87–93 pitfalls and danger points in, 85 postoperative care in, 93 preoperative preparation for, 85 splenic injury prevention in,

85–86

suture line disruption in, 86 suturing of the fundoplication

in, 91–92

tightness of the fundoplication, 86, 91–92

in transthoracic gastroplasty, 122, 123, 124, 126

P

Palliative treatment, of unresectable esophageal carcinoma, 2 Pancreatitis, hemorrhagic, 34 Pedicle flaps, in esophageal

perforation repair, 151 Penrose drains, 68–69 pH, esophageal, 5

Phrenoesophageal ligaments, division of, 108, 109 Pledgets, Teflon, 92

Pleural flap repair, of thoracic esophageal perforation, 150–152

Pneumothorax

esophageal perforation-related, 9

tension

laparoscopic Nissen fundoplication-related, 95

transhiatal esophagectomy- related, 68

Proton pump inhibitors, 5, 6 Pseudoachalasia, 11

Pulmonary complications, of esophagectomy, 33 Pyloromyotomy

in esophagectomy, 21–23 in esophagogastrectomy with

left thoracoabdominal approach, 45

in jejunum interposition, 83 in long segment colon

interposition, 77

in transhiatal esophagectomy, 67, 70

Pyloroplasty, in jejunum interposition, 83

R

Recurrent laryngeal nerve

cricopharyngeal myotomy-related palsy of, 138

in esophagogastrectomy with left thoracoabdominal approach, 52, 53

transhiatal esophagectomy- related injury to, 66–67 Retractors

Army-Navy, 112 esophageal, 100–102 Finochietto, 17, 23, 50, 116 Harrington, 17

liver, 96, 97 Thompson, 17, 85

Weinberg blade o, 67 Upper Hand, 85 Weinberg, 17

Roux-en-Y reconstructions in bile diversion operations, 7,

127, 128

duodenojejunostomy switch operation, 131–132

following esophagogastrectomy, 128–129, 130

following failed antireflux operations, 127

with vagotomy and antrectomy, 128

as delayed gastric emptying cause, 7

esophagojejunosomy, 1

S

Scissors, Metzenbaum, 21, 38, 108 Sepsis

esophageal perforation repair- related, 155

esophagogastrectomy-related, 36 Short gastric vessels, division of

in Nissen fundoplication, 95, 102, 103–105

in transthoracic gastroplasty, 121 Small intestine, herniation of, Nissen

fundoplication-related, 95, 102

Spasms, esophageal, diffuse, esophagomyotomy for, 139, 143

Spleen, intraoperative injury to laparoscopic Nissen

fundoplication-related, 95 posterior gastropexy-related, 107,

110–111

transabdominal Nissen

fundoplication-related, 85–86 transhiatal esophagectomy-related,

66

transthoracic gastroplasty-related, 115

Splenectomy, in

esophagogastrectomy with left thoracoabdominal approach, 40, 42 Sponge-holders, 68 Stenosis, of anastomosis, 33 Stomach

decompression of, 154–155 herniation of, laparoscopic Nissen

fundoplication-related, 95, 102

involvement in paraesophageal hernias, 5

laparoscopic Nissen

fundoplication-related injury to, 95

mobilization of

in esophagectomy, 17–20 in esophagogastrectomy, 42–45 in esophagogastrectomy with

left thoracoabdominal approach, 42–45

in transthoracic gastroplasty, 115

transection of, in

esophagogastrectomy, 45–48 volvulus of, 5

Stomach cancer,

esophagogastrectomy treatment of, 34–65

Stomach interposition, in esophageal

replacement, 3

Strictures, esophageal cervical leaks-related, 2

dilation of, during transthoracic gastroplasty, 120–121 gastroesophageal reflux-related,

6–7

surgical treatment of, 6–7 with colon or jejunum interpositions, 73–83 with esophagogastrectomy,

34–65

with transhiatal esophagectomy, 66–71

Surgical legacy techniques

esophageal anastomosis stapling technique, 52, 54–58

posterior gastropexy (Hill repair), 107–114

T

Thoracic duct, transhiatal

esophagectomy-related injury to, 66

Thoracotomy, right

for azygos vein trauma-related hemorrhage control, 67 with esophagectomy, 13–33 in gastric cardia carcinoma, 1 in midthoracic esophageal

carcinoma resection, 1–2 Total parenteral nutrition, 155

Trachea, membranous, transhiatal esophagectomy-related laceration of, 66

V Vagotomy

in bile diversion procedures, 127, 128 in esophageal replacement, 3, 4 inadvertent, transthoracic

gastroplasty-related, 115 Vagus nerves

anterior, 98

in esophageal perforation repair, 153, 154

in esophagogastrectomy with left thoracoabdominal approach, 40, 41

hepatic branch of, in transabdominal Nissen fundoplication, 85 left

division of, 67

in esophagogastrectomy, 45 in posterior gastropexy (Hill

repair), 108

in transabdominal Nissen fundoplication, 87, 90 right

division of, 67

in posterior gastropexy (Hill repair), 108

in transabdominal Nissen fundoplication, 87, 90 Vena cava

posterior gastropexy-related injury to, 107

transabdominal Nissen

fundoplication-related injury to, 85

Venous compression,

esophagectomy-related, 13 Volvulus, gastric, 5

Vomiting, as thoracic esophageal perforation cause, 9

Y

Yeast, esophageal content of, 8

Z

Zenker’s (pharyngoesophageal) diverticulum, cricopharyngeal myotomy and operation for, 134–138

closure of, 138 complications of, 138

dissection technique in, 136–137

incision and exposure in, 134–136

myotomy technique in, 137–138

operative strategy in, 134

operative technique in, 134–138

postoperative care folowing, 138

preoperative preparation for, 134